• Utilization & Disease

    CenterWell (Tallahassee, FL)
    …healthcare industry. The UM Administration Coordinator - Phone Intake contributes to administration of utilization management . The UM Administration ... works on semi-routine assignments. Shift Hours - 8a - 5 The UM Administration Coordinator - Phone Intake provides non-clinical support for the policies and… more
    CenterWell (05/16/25)
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  • Fee Basis Physician (Radiation Oncology)

    Veterans Affairs, Veterans Health Administration (West Palm Beach, FL)
    …systems of health care by participating in programs, following policies, improving utilization of resources and suggesting process changes for clinical programs in ... the Radiation Oncology Section. NOTE: The utilization of the Fee Basis appointments are focused on...clinical staff of current automated technology for Health Information Management Sections (HIMS), patient data tracking, patient orders, etc.… more
    Veterans Affairs, Veterans Health Administration (03/09/25)
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  • Physician (Primary Care)

    Veterans Affairs, Veterans Health Administration (Bradenton, FL)
    …age appropriate cervical and breast cancer screening, menopause and contraceptive management , and initial evaluation of basic gynecological concerns. Performs a ... variety of disease prevention related activities including gender and age specific...and treatment as appropriate. Provide Buprenorphine treatment in the management of Opioid Use Disorder per DEA guidance. Primary… more
    Veterans Affairs, Veterans Health Administration (05/16/25)
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  • Medical Director (Medicare)

    Molina Healthcare (Tampa, FL)
    …HMO regulations, managed healthcare systems, quality improvement, medical utilization management , risk management , risk adjustment, disease management ... Summary** Responsible for serving as the primary liaison between administration and medical staff. Assures the ongoing development and...resource management . + Develops and implements a Utilization Management program and action plan, which… more
    Molina Healthcare (05/02/25)
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  • Medical Director Specialty Medical Services…

    Molina Healthcare (Jacksonville, FL)
    …HMO regulations, managed healthcare systems, quality improvement, medical utilization management , risk management , risk adjustment, disease management ... and effective resource management . + Develops and implements a Utilization Management program and action plan, which includes strategies that ensure… more
    Molina Healthcare (04/09/25)
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  • Chief Medical Officer AdventHealth Heart…

    AdventHealth (Davenport, FL)
    …and performance excellence . Develops, monitors, and evaluates performance/process improvement, disease management , utilization review activities, and ... members of the medical staff on regulatory updates and changes related to CDI,HIM, utilization management and care management . Serves as a community resource… more
    AdventHealth (04/29/25)
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  • Chief Medical Officer

    HCA Healthcare (Fort Pierce, FL)
    … review/ management + You will consult with facility-level staff regarding delegated utilization management and disease management operations under ... ongoing in-service programs to facility medical staff regarding clinical resource management , appropriate documents standards, utilization and quality issues,… more
    HCA Healthcare (05/17/25)
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  • Physician Advisor

    AdventHealth (Orlando, FL)
    …and serves as a resource to Medical Staff colleagues regarding best practices, Utilization Management and Care Management structures, and functions and ... facilitates productive internal/external relationships with all physicians and constituents of Utilization Management , Care Management and CDI departments.… more
    AdventHealth (05/15/25)
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  • Field Medical Director, Cardiology

    Evolent (Tallahassee, FL)
    …Doing:** As a Cardiology, Field Medical Director you will be a key member of the utilization management team. We can offer you a meaningful way to make a ... the Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. +… more
    Evolent (05/16/25)
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  • Market CMO

    CenterWell (Daytona Beach, FL)
    …providing medical guidance and expertise. + Develop, implement, and monitor the outcomes of utilization review and disease management programs to meet the ... Responsible for medical interpretation, reviews, and decisions as required for plan administration . + Monitor medical performance and provide guidance to ensure that… more
    CenterWell (03/21/25)
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  • PCP/Endo Business Specialist - St. Petersburg, FL

    Boehringer Ingelheim (St. Petersburg, FL)
    …on "continuation of care" model, including discharge protocol, treatment algorithms, disease management , etc. Analyzes qualitative and quantitative territory ... supporting analysis tools to plan activity, report and monitor resource utilization , and maintain account and customer records. Completes all administrative… more
    Boehringer Ingelheim (05/02/25)
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  • Biological Scientist I

    MyFlorida (Orlando, FL)
    …to the prevention and control of Tuberculosis (TB). The position serves as a Disease Intervention Specialist (DIS) working with experienced DIS to learn to work with ... ensure treatment is completed as prescribed. Participates in case management meetings and notifies supervisor and case managers of...Supervisor, to determine origin of TB Infection or TB Disease in contacts. Meets with supervisor daily to ensure… more
    MyFlorida (04/23/25)
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  • Clinical Information Systems Specialist

    Molina Healthcare (Jacksonville, FL)
    …clinical systems analysis, or equivalent experience * 2 or more years in case, disease , or utilization management ; managed care; or medical/behavioral health ... development, implementation, and collaboration with the delivery of training curriculum for Utilization Management , Case Management , and LTSS staff. **Job… more
    Molina Healthcare (05/08/25)
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  • Chief Medical Officer AdventHealth

    AdventHealth (Daytona Beach, FL)
    …risk management . . Experienced and demonstrated success in leading case management , disease management , and/or population health programs. . Demonstrates ... case management , appropriate levels of care for patients, efficient utilization of resources(including appropriate length of stay, consult usage and turn-around… more
    AdventHealth (03/12/25)
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  • Medical Director

    Highmark Health (Tallahassee, FL)
    …:** **JOB SUMMARY** This job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the highest and ... participates as the physician member of the multidisciplinary team for case and disease management . They will advise the multidisciplinary team on cases,… more
    Highmark Health (05/07/25)
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  • Human Services Program Consultant II

    MyFlorida (Orlando, FL)
    …Community Based Organizations (CBO's). Incumbent reports directly to the Supervisor of Case Management . Staff will establish and maintain a caseload of no more than ... complete and scan documents into the State and RWHAP systems, Health Management System (HMS) and Provide. Staff, in coordination with SCC Referral Specialists,… more
    MyFlorida (04/08/25)
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  • Associate Chair of Clinical Operations & Aso/Full…

    University of Florida (Jacksonville, FL)
    …and decision support tools. This may include development, refinement and integration of utilization and disease management programs that outline services and ... Practice Providers Responsibilities Include: + Providing direct leadership and management to clinical faculty including setting productivity and quality goals,… more
    University of Florida (05/04/25)
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  • Executive Procedure Development Executive - Lung…

    Medtronic (Orlando, FL)
    …clinical success, including procedural sales, growth of consumables, driving overall utilization of the Medtronic Lung Health portfolio, and identifying/assisting in ... the peripheral lung biopsy market by increasing ILLUMISITE (TM) procedure utilization + Expand the commercialization of ILLUMISITE (TM) and its differentiated… more
    Medtronic (05/15/25)
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  • Environmental Specialist II

    MyFlorida (Fort Myers, FL)
    …conditions propagating sanitary nuisances, and overcrowding to prevent environmentally transmitted disease per Ch. 381.006(14) FS; Ch. 513 FS; and Ch. 64E-16 ... minutes. Performs other duties as assigned. Knowledge, skills and abilities, including utilization of equipment, required for the position: + Knowledge, skills and… more
    MyFlorida (03/18/25)
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  • Senior Community Health Nurse - 1

    MyFlorida (Bradenton, FL)
    …name, address, medical, social and financial data and services received. Sexually transmitted disease and pregnancy information is of a more sensitive nature and is ... in the absence of the Health Support Tech. or LPN, including administration of medications, special procedures, contacting parents and counseling students regarding… more
    MyFlorida (05/16/25)
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